FP-C 2026 Study Guide Flight Paramedic Certification
Practice Questions, Answer Explanations, Critical Care
Transport, Airway, Trauma, Pharmacology, Exam
Preparation
DOMAIN 1: FLIGHT PHYSIOLOGY (8%)
Gas Laws and Altitude Physiology
Question 1. As altitude increases, which statement correctly describes the behavior
of atmospheric gases?
A. The percentages and total pressure of gases are increased.
B. The percentages of gases increase as the total gas pressure decreases.
C. The percentages of gases are unchanged, but the total pressure of the gases
decreases.
D. The percentages of gases decrease and the total gas pressure remains the same.
Rationale: The fractional concentration of oxygen (FiO₂) remains constant at 0.21
regardless of altitude. However, as altitude increases, the total atmospheric
pressure decreases, which reduces the partial pressure of oxygen (PaO₂) and
impairs oxygen loading at the alveolar level. This is the fundamental mechanism of
hypobaric hypoxia in flight.
Question 2. A patient with a 10 mL untreated pneumothorax is transported to an
altitude of 8,000 feet cabin pressure. According to Boyle's Law, what is the
approximate volume of the pneumothorax at altitude?
A. 8.5 mL
B. 10 mL
C. 13.4 mL
D. 20 mL
Rationale: Boyle's Law states that at constant temperature, gas volume is inversely
proportional to pressure. At 8,000 feet, cabin pressure is approximately 75% of
sea-level pressure, so the gas volume expands by approximately 34%. A 10 mL
,pneumothorax becomes approximately 13.4 mL, potentially progressing to a
tension pneumothorax. This is why chest decompression is considered before air
transport in at-risk patients.
Question 3. Which gas law explains why a patient with a closed-loop bowel
obstruction may experience increased abdominal distension during flight?
A. Boyle's Law
B. Dalton's Law
C. Henry's Law
D. Charles's Law
Rationale: Boyle's Law explains that gas volume increases as altitude increases
and pressure decreases. In a closed-loop bowel obstruction, trapped gas will
expand at altitude, increasing abdominal distension, pain, and the risk of ischemia
or perforation. Nasogastric decompression is recommended before air transport.
Question 4. Dalton's Law at altitude means that:
A. The percentage of oxygen increases to compensate for lower pressure.
B. The partial pressure of each gas in a mixture is proportional to its
fractional concentration and the total pressure.
C. Gas dissolves in liquids in proportion to its partial pressure.
D. Gas volume increases as temperature increases.
Rationale: Dalton's Law states that the total pressure of a gas mixture equals the
sum of the partial pressures of each gas. At altitude, the fractional concentration of
oxygen remains 21%, but the partial pressure of oxygen decreases because total
atmospheric pressure decreases.
Question 5. A diver who surfaces too quickly is at risk for decompression
sickness. Which gas law best explains this phenomenon?
A. Boyle's Law
B. Dalton's Law
C. Henry's Law
D. Charles's Law
,Rationale: Henry's Law states that the amount of gas dissolved in a liquid is
proportional to the partial pressure of that gas above the liquid. When a diver
ascends rapidly, dissolved nitrogen comes out of solution and forms bubbles in
tissues and blood, causing decompression sickness.
Question 6. At 25,000 feet without supplemental oxygen, the time of useful
consciousness (TUC) is approximately:
A. 5–10 minutes
B. 3–5 minutes
C. 1–2 minutes
D. 30–60 seconds
Rationale: The time of useful consciousness at 25,000 feet is approximately 3–5
minutes. At 35,000 feet, it decreases to 30–60 seconds, and at 45,000 feet, it is 9–
12 seconds. These times are critical for recognizing and responding to hypoxia in
flight.
Question 7. Which type of hypoxia is caused by inadequate oxygen delivery due
to low cardiac output?
A. Stagnant hypoxia
B. Hypoxic hypoxia
C. Anemic hypoxia
D. Histotoxic hypoxia
Rationale: Stagnant (circulatory) hypoxia occurs when blood flow to tissues is
inadequate, such as in shock or heart failure. Hypoxic hypoxia results from low
PaO₂, anemic hypoxia from reduced oxygen-carrying capacity, and histotoxic
hypoxia from impaired tissue utilization of oxygen.
Cabin Pressure and Decompression
Question 8. Which of the following is a sign of decompression sickness (DCS)?
, A. Bradycardia
B. Joint pain (the bends)
C. Hypertension
D. Hypothermia
Rationale: Joint pain, known as "the bends," is the most common symptom of
decompression sickness. Other symptoms include chest pain, cough, neurological
deficits, and skin manifestations. DCS requires immediate hyperbaric oxygen
therapy.
Question 9. During an inadvertent decompression at altitude, what is the FIRST
action the flight crew should take?
A. Don oxygen masks and initiate emergency descent
B. Administer oxygen to the patient only
C. Continue to the destination
D. Increase cabin pressure
Rationale: During decompression, the first action is to don oxygen masks and
initiate an emergency descent to a safe altitude (typically 10,000 feet or below).
Crew safety is paramount before patient care can be effectively delivered.
Question 10. A patient with a pneumothorax is being transported by air. Which of
the following is the MOST appropriate intervention?
A. No intervention needed
B. Chest tube placement if not already in place, or needle decompression if needed
C. Chest tube placement or needle decompression before flight, if indicated
D. Increase cabin pressure
Rationale: Any untreated pneumothorax can expand at altitude due to Boyle's
Law, potentially becoming a tension pneumothorax. Chest decompression (needle
or tube thoracostomy) is indicated before air transport in patients with
pneumothorax.
DOMAIN 2: ADVANCED AIRWAY AND VENTILATION (18%)
Practice Questions, Answer Explanations, Critical Care
Transport, Airway, Trauma, Pharmacology, Exam
Preparation
DOMAIN 1: FLIGHT PHYSIOLOGY (8%)
Gas Laws and Altitude Physiology
Question 1. As altitude increases, which statement correctly describes the behavior
of atmospheric gases?
A. The percentages and total pressure of gases are increased.
B. The percentages of gases increase as the total gas pressure decreases.
C. The percentages of gases are unchanged, but the total pressure of the gases
decreases.
D. The percentages of gases decrease and the total gas pressure remains the same.
Rationale: The fractional concentration of oxygen (FiO₂) remains constant at 0.21
regardless of altitude. However, as altitude increases, the total atmospheric
pressure decreases, which reduces the partial pressure of oxygen (PaO₂) and
impairs oxygen loading at the alveolar level. This is the fundamental mechanism of
hypobaric hypoxia in flight.
Question 2. A patient with a 10 mL untreated pneumothorax is transported to an
altitude of 8,000 feet cabin pressure. According to Boyle's Law, what is the
approximate volume of the pneumothorax at altitude?
A. 8.5 mL
B. 10 mL
C. 13.4 mL
D. 20 mL
Rationale: Boyle's Law states that at constant temperature, gas volume is inversely
proportional to pressure. At 8,000 feet, cabin pressure is approximately 75% of
sea-level pressure, so the gas volume expands by approximately 34%. A 10 mL
,pneumothorax becomes approximately 13.4 mL, potentially progressing to a
tension pneumothorax. This is why chest decompression is considered before air
transport in at-risk patients.
Question 3. Which gas law explains why a patient with a closed-loop bowel
obstruction may experience increased abdominal distension during flight?
A. Boyle's Law
B. Dalton's Law
C. Henry's Law
D. Charles's Law
Rationale: Boyle's Law explains that gas volume increases as altitude increases
and pressure decreases. In a closed-loop bowel obstruction, trapped gas will
expand at altitude, increasing abdominal distension, pain, and the risk of ischemia
or perforation. Nasogastric decompression is recommended before air transport.
Question 4. Dalton's Law at altitude means that:
A. The percentage of oxygen increases to compensate for lower pressure.
B. The partial pressure of each gas in a mixture is proportional to its
fractional concentration and the total pressure.
C. Gas dissolves in liquids in proportion to its partial pressure.
D. Gas volume increases as temperature increases.
Rationale: Dalton's Law states that the total pressure of a gas mixture equals the
sum of the partial pressures of each gas. At altitude, the fractional concentration of
oxygen remains 21%, but the partial pressure of oxygen decreases because total
atmospheric pressure decreases.
Question 5. A diver who surfaces too quickly is at risk for decompression
sickness. Which gas law best explains this phenomenon?
A. Boyle's Law
B. Dalton's Law
C. Henry's Law
D. Charles's Law
,Rationale: Henry's Law states that the amount of gas dissolved in a liquid is
proportional to the partial pressure of that gas above the liquid. When a diver
ascends rapidly, dissolved nitrogen comes out of solution and forms bubbles in
tissues and blood, causing decompression sickness.
Question 6. At 25,000 feet without supplemental oxygen, the time of useful
consciousness (TUC) is approximately:
A. 5–10 minutes
B. 3–5 minutes
C. 1–2 minutes
D. 30–60 seconds
Rationale: The time of useful consciousness at 25,000 feet is approximately 3–5
minutes. At 35,000 feet, it decreases to 30–60 seconds, and at 45,000 feet, it is 9–
12 seconds. These times are critical for recognizing and responding to hypoxia in
flight.
Question 7. Which type of hypoxia is caused by inadequate oxygen delivery due
to low cardiac output?
A. Stagnant hypoxia
B. Hypoxic hypoxia
C. Anemic hypoxia
D. Histotoxic hypoxia
Rationale: Stagnant (circulatory) hypoxia occurs when blood flow to tissues is
inadequate, such as in shock or heart failure. Hypoxic hypoxia results from low
PaO₂, anemic hypoxia from reduced oxygen-carrying capacity, and histotoxic
hypoxia from impaired tissue utilization of oxygen.
Cabin Pressure and Decompression
Question 8. Which of the following is a sign of decompression sickness (DCS)?
, A. Bradycardia
B. Joint pain (the bends)
C. Hypertension
D. Hypothermia
Rationale: Joint pain, known as "the bends," is the most common symptom of
decompression sickness. Other symptoms include chest pain, cough, neurological
deficits, and skin manifestations. DCS requires immediate hyperbaric oxygen
therapy.
Question 9. During an inadvertent decompression at altitude, what is the FIRST
action the flight crew should take?
A. Don oxygen masks and initiate emergency descent
B. Administer oxygen to the patient only
C. Continue to the destination
D. Increase cabin pressure
Rationale: During decompression, the first action is to don oxygen masks and
initiate an emergency descent to a safe altitude (typically 10,000 feet or below).
Crew safety is paramount before patient care can be effectively delivered.
Question 10. A patient with a pneumothorax is being transported by air. Which of
the following is the MOST appropriate intervention?
A. No intervention needed
B. Chest tube placement if not already in place, or needle decompression if needed
C. Chest tube placement or needle decompression before flight, if indicated
D. Increase cabin pressure
Rationale: Any untreated pneumothorax can expand at altitude due to Boyle's
Law, potentially becoming a tension pneumothorax. Chest decompression (needle
or tube thoracostomy) is indicated before air transport in patients with
pneumothorax.
DOMAIN 2: ADVANCED AIRWAY AND VENTILATION (18%)
